In this week's sexual health round up: we have hit an expected but dreaded milestone with the first document cases of cephalosporin-resistant gonorrhea in North America; a major porn producer sues the city of Los Angeles to stop the enforcement of an on-set condom requirement; and study shows that an age-old herb might work just as well as modern prescription drugs for erectile issues.

A study released last week by the Journal of the American Medical Association (JAMA) reports that cephalosporin-resistant gonorrhea has reached North America. Researchers followed 300 patients at a Toronto clinic who were treated for gonorrhea with cefixime between May 2010 and April 2011. They wanted to determine how many of them were still infected when they came back for their follow-up test. Of the 133 who returned for testing, 13 were still infected by only nine said that there was no chance it was a re-infection. This represents 6.7 percent of patients or roughly one in 15 who had a resistant strain of the bacteria. The patients who remained infected were successfully treated with IV ceftriaxone (also a cephalosporin) but these cases remain troubling as do the cases of those who did not return for re-testing.

These are the first documented cases of cephalosporin-resistant gonorrhea in North America. Cases had previously been documented in the United Kingdom, Austria, France, Norway, and Japan.

Public health experts are not surprised. As Dr. Robert Kirkcaldy of the Centers for Disease Control and Prevention (CDC) wrote in his editorial in this issue of JAMA:

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“Cephalosporin treatment failures have now been documented in North America. Although this milestone was expected, its arrival is deeply troubling.”

In preparation for this milestone, the CDC released new treatment guidelines over the summer which suggests that health care providers no longer rely on one oral antibiotic to treat initial infection. The new guidelines instead recommend that infection be treated with injectable ceftriaxone in combination with one of two oral antibiotics—doxycycline or azithromycin. The real problem, however, is what will happens if/when ceftriaxone no longer works as it remains the last line of defense and no new drugs are in the pipeline.

The results found in this study are not generalizable as they all came from the same clinic. Still, public health experts agree it is time to be even more vigilant in tracking, treating, and following up with cases of gonorrhea.

Porn Producer Sues to Block Condom Law

For years, the AIDS Healthcare Foundation has been on a mission to require adult film stars to use condoms while filming. After many failed attempts, they took it the voters this fall in the form of a ballot measure that ultimately passed. Measure B requires adult film producers to apply for a permit from the county Department of Public Health in order to shoot sex scenes. The city will then use the fees from these permits to pay for periodic inspections of sets to ensure that actors are using condoms.

The measure is limited, however, in that it only applies to films shot on location within the city limits. Films shot on sets are excluded. Moreover, the city has not started enforcing the measure as it cannot figure out a cost-effective way to do so.

Now, an adult film producer has gone to court to block measure before it even gears up. Vivid Entertainment—makers of My Slutty Friends, Cathouse 45, and Three Way—sued the city on Thursday arguing that Measure B violates the First Amendment right to free speech and expression. They also argued that the adult industry already has safeguards in place to protect performers from HIV and other STDs including regular blood testing. Finally, the suit argues that the law is vague, burdensome, and ineffective, and that state regulations pre-empt the law’s authority anyhow. It asks the court to prevent the law from being enforced and to rule it unconstitutional.

“Overturning this law is something I feel very passionate about. I believe the industry’s current testing system works well. Since 2004 over 300,000 explicit scenes have been filmed with zero HIV transmission. The new law makes no sense and it imposes a government licensing regime on making films that are protected by the Constitution.”

Critics of the law say that viewers don’t want to see condom use and argue that filmmakers will simply take their productions outside the city which will be bad for the Los Angeles.

Better Erections May Be Found in the Health Food Store

Men who are experiencing mild erectile dysfunction may find their solution in an age-old herb rather than a child-proof prescription bottle. Scientists in South Korea enrolled 100 men who were experiencing erectile problems in a study. The men were divided into two groups; one took daily pills containing ginseng extract and the other a placebo. After eight weeks, researchers measured their progress using the International Index of Erectile Dysfunction. They found that those taking the ginseng showed a small but significant improvement in overall sexual function compared to the control group. The results were published in the International Journal of Impotence Research.

Ginseng has been used in Chinese medicine for thousands of years and previous research has suggested that it helps with sexual functioning (though the many of the existing formal studies have been conducted in mice).

This new study gives men an alternative to conventional medical treatments such as Viagra, Cialis, and Levitra. Researchers say it may be particularly helpful to the roughly 30 percent of men who are not helped by these other drugs.